MEDICARE: BRUCE A. BRAZINSKY, A PODIATRY CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E3870	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480025320	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396741997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE A. BRAZINSKY, A PODIATRY CORPORATION

Provider Business Mailing Address
First Line	:	6699 ALVARADO RD
Second Line	:	STE 2201
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5253
Country	:	US
Telephone Number	:	619-583-8592
Fax Number	:	619-583-8170

Provider Business Practice Location Address
First Line	:	6699 ALVARADO RD
Second Line	:	STE 2201
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5253
Country	:	US
Telephone Number	:	619-583-8592
Fax Number	:	619-583-8170

Authorized Official
Title or Position	:	PODIATRIST/OWNER
Name	:	DR. BRUCE ALLEN BRAZINSKY
Credential	:	DPM
Telephone Number	:	619-583-8592

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	03/07/2023

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Directions to “BRUCE A. BRAZINSKY, A PODIATRY CORPORATION ” Practice Location

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